| NPI | 1225080344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 104186) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 44623) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2022-07-21 |